†These authors contributed equally.
Academic Editor: Rosa Alduina
Background: Impaired glucose regulation (IGR)
represents the prediabetic state and is associated with gut microbiota (GM)
dysbiosis and chronic inflammation. Tangning Ziyabitusi Tablet (TZT) is a Chinese
Uyghur herbal medicine with preventative and therapeutic effects on diabetes, but
its hypoglycemic mechanisms are unclear. Methods: Thirty-six male Wistar
rats were divided into the normal diet (ND) and IGR groups. The IGR group was
given a high-fat diet (HFD). After the IGR model establishment, the ND group was
divided into ND and ND+TZT groups, and the IGR group into IGR and IGR+TZT groups.
After 8 weeks of TZT administration, 16S rRNA sequencing and untargeted
metabolomics were performed on fecal samples. Mesenteric lymph nodes were also
collected, and T lymphocytes separated after rats were sacrificed. Flow cytometry
was used to characterize different CD4
Impaired glucose regulation (IGR) is a pre-diabetes state and includes impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) [1]. According to diagnostic criteria from the American Diabetes Association in 2017, the prevalence of IGR in Chinese adults was 35.2%, which was much higher than the weighted prevalence of total diabetes at 11.2% [2]. According to recent statistics, approximately 70% of patients with IFG and IGT eventually develop diabetes [3]. Therefore, key stages of diabetes prevention and treatment should be assessed at the IGR stage, thus, it is important to effectively intervene at this stage to delay or reduce diabetes [4]. However, some clinical drugs such as biguanides cause mild to severe side effects. Therefore, the identification of Chinese herbal medicine agents to treat diabetes has attracted considerable research interest.
In recent years, the relationship between T2DM and gut microbiota (GM) has received increasing attention. GM is a symbiotic micro-ecosystem in the body and plays important role in regulating metabolism [5, 6]. Allin et al. [7] reported that the IGR population had GM dysbiosis; Clostridium spp. abundance was significantly reduced, while Ruminococcus abundance was significantly increased, suggesting GM changes in IGR. Moreover, in our previous study [8], we showed that Sobs and Shannon indices of GM in the IGR population decreased significantly, while the Simpson index increased significantly when compared with the healthy population. The Sobs index refers to the number of operational taxonomic units (OTUs) observed, which can reflect the species richness. The Shannon index is used to describe the disorder and uncertainty that occur in individuals of a species, the higher the uncertainty reflects the higher the diversity. Simpson index represents the probability that the number of individuals obtained from two consecutive samplings from a community species belongs to the same species, and also can indicate the diversity of the community. Therefore, studying the relationships between GM dysbiosis and IGR has important clinical significance for preventing and treating T2DM.
Not only are there more than 10
Recent studies reported that traditional Chinese herbal medicines such as berberine can regulate the compositional ratio of beneficial and harmful bacteria, inhibit inflammation caused by GM dysbiosis, and generate good results for the clinical treatment of T2DM [15, 16, 17, 18]. Tangning Ziyabitusi Tablet (TZT) is a traditional herbal medicine formula composed of herbal medicine Acorns, Frankincense, Bletilla striata, Pomegranate flowers, Eucalyptus vulgaris, Galangal, Tianzhu Huang, etc. Studies have shown that Acorns and Frankincense, the main components of TZT, have certain therapeutic effects on diabetes [19, 20]. Studies from humans have shown that among the 219 diabetic patients treated with TZT, 78 cases had their blood glucose reduced to 7 mmol/L, accounting for 36% of them recovered; the total number of hypoglycemic effective patients is 167 cases, accounting for 76%. TZT regulated liver and kidney function, reduced urine levels and body weight, and was effective in the clinical treatment of diabetes [21]. However, the exact mechanism and whether the hypoglycemic effect of TZT is regulated by GM remains unclear.
Therefore, we observed the antidiabetic effects of TZT in a high-fat diet (HFD)-induced IGR model in rats. We studied GM changes in response to TZT treatment and the potential link between GM and T cell subsets in mesenteric lymph nodes. Our study provides an increased understanding of the potential TZT mechanisms for diabetes attenuation.
Animal protocols were approved by the Animal Research Committee of Xinjiang Medical University (Urumqi, China). Specific pathogen-free (SPF) male Wistar rats were purchased from the Animal Experiment Center of Xinjiang Medical University and housed in a controlled environment (12 h light/dark cycle) with free access to water. All experiments were approved by the ethics committee of Xinjiang Medical University (Permit Number: IACUC-20201026-24). Experimental diets, comprising normal diet (ND) (10% calories from fat, 20% calories from protein, and 70% calories from carbohydrate, MD12031) and the HFD (45% calories from fat, 20% calories from protein, and 35% calories from carbohydrate, MD12032), were purchased from Jiangsu Medison Biomedical Technology Co. Ltd (Nanjing, China).
Male SPF Wistar rats (aged 6 weeks) were adapted to the laboratory environment by feeding an ND for one week before studies. At 7 weeks old, 36 rats were randomly divided into ND and IGR groups. The ND group was received normal diet and the IGR group was fed HFD for 14 weeks. From the 6th week, an oral glucose tolerance test (OGTT) was performed every 2 weeks. According to the American Diabetes Association diabetes diagnosis and classification criteria, a successful IGR rat model comprised: Fasting plasma glucose (FPG) 5.6–6.9 mmol/L or a 2 hour postprandial blood glucose (2 h PG) of 7.8–11.1 mmol/L.
The two groups were further divided into four groups: ND, ND+TZT, IGR, and IGR+TZT groups. TZT was purchased from the hospital of Kashgar traditional Uyghur medicine (new drug name M20040974, Kashgar, China) and was dissolved in distilled water and administered by daily intragastric gavage at 308 mg/kg body weight. This dose was safe according to our pre-experiment. An equal volume of distilled water was given to the ND group. Body weight and food intake were measured weekly. After 8 weeks of intragastric administration, rats were anesthetized using 2.5% sodium pentobarbital (2 g/kg body weight) after 12 h starvation and humanely sacrificed by cardiac puncture. Blood was collected and serum separated by centrifugation. Organs and tissues were collected, weighed, and frozen at –80 °C.
For OGTT, rats were fasted for 12 h after which blood glucose was measured using the tail clipping method, and followed by gavage with distilled water or 50% glucose at 2 g/kg body weight. Blood glucose levels were measured at indicated time point. For ITT, rats were fasted for 6 h during the light cycle. Distilled water or insulin (INS) (recombinant human insulin, Solarbio, Beijing, China, 0.75 units/kg) was injected intraperitoneally, and blood glucose levels were assayed at indicated time points after insulin injection. Blood glucose levels were measured using Roche’s Blood Glucose Meter and Test Strips (AUUC-CHEK Performa Zhuoyuejingcai Glucose Meter, Roche Diabetes Care GmbH, Mannheim, Germany).
Serum INS, interleukin-2 (IL-2), tumor necrosis factor
(TNF-
Fecal samples were randomly selected from groups (n = 6/group). DNA quality, after using a bacterial gDNA stool extraction kit (Qiagen, Hilden, Germany), was visually assessed by 1% agarose gel electrophoresis. We used the V3-V4 hypervariable region of 16S rRNA and barcoded universal primers (forward 338F: 5′-ACTCCTACGGGAGGCAGCAG-3′; reverse 806R: 5′-GGACTACHVGGGTWTCTAAT-3′) to amplify DNA. Next, sequencing libraries were generated using TruSeq DNA PCR-free sample preparation kits (QIAGEN, USA). After assessing DNA quality, the library was sequenced using the Illumina MiSeq platform, with a sequencing length of 300 base pair (bp) paired-end reads (Shanghai Majorbio Bio-Pharm Technology, Shanghai, China).
We used fastp [22] (https://github.com/OpenGene/fastp, version 0.20.0) software
for the quality control of raw sequencing sequences, and FLASH [23]
(http://www.cbcb.umd.edu/software/flash, version 1.2.7) software for splicing.
Sequences were aligned using the Silva database of bacterial 16S rRNA
(http://www.arb-silva.de) at a 70% confidence level using VSEARCH software.
Operational taxonomic units (OTUs) were identified as one cluster at the 97%
similarity level. Using UPARSE software [24] (http://drive5.com/uparse/, version
7.1), sequences were OTU clustered according to 97% similarity [24].
Subsequently, Mothur software (v1.35.1, http://www.mothur.org/) was used for
rarefaction curve analysis, and
Rat mesenteric lymph nodes were collected and grounded, and grounded liquid was
filtered through a 200-mesh nylon mesh into a 15 mL centrifuge tube, centrifuged
at 1500 rpm for 5 min to collect the cells, and the supernatant was discarded; an
appropriate volume of PBS was taken to resuspend the cell pellet, and filtered
through a 200-mesh nylon mesh into a new 15 mL centrifuge tube to prepare single
cell suspension. Fluorescently conjugated antibodies fluoresce in isothiocyanate
(FITC)-anti-CD4PE-anti-CD25 and Allophycocyanin, (APC)-anti-FOXP3 were used to
label cells, while flow cytometry was used to detect Treg
(CD4
Frozen stool samples were thawed at 4 °C and untargeted fecal metabolomics analyses based on LC-MS were performed according to our previous study [25].
Statistical analysis was performed in GraphPad Prism 8.0 (GraphPad Software, San Diego, CA, USA ). Data was presented as the mean
The average body weight of the IGR group was significantly higher than the ND group after 4 weeks of feeding (Fig. 1A). Glucose tolerance was impaired in the IGR group after 14 weeks (Fig. 1B,C) and insulin resistance developed at week 15 (Fig. 1D,E). Therefore, a rat IGR model was successfully established according to ADA criteria.
Establishment of a rat IGR model. (A) Body weight change in the ND and IGR groups. (B–C) Result of OGTT after 14 weeks in the ND and IGR groups. (D–E) Result of ITT after 15 weeks in ND and IGR groups (n = 6/group).
To evaluate the antidiabetic effects of TZT, rats in the IGR group were administered 308 mg/kg/day TZT or vehicle by gavage for 8 weeks, starting from 7 weeks old. The HFD increased body weight when compared with ND-fed animals (Fig. 2A). In contrast, TZT administration attenuated body weight gain in IGR rats (Fig. 2A). OGTT results showed that IGT in the IGR+TZT group was improved when compared with the IGR group (Fig. 2B,C), and ITT data showed that insulin resistance was improved in the IGR+TZT group when compared with the IGR group (Fig. 2D,E). Thus, TZT administration attenuated HFD-induced IGR and insulin resistance.
The effects of TZT on plasma glucose and insulin levels in IGR rats. (A) Body weight over the 8-week of TZT intervention. (B–C) PG levels at 2 h were tested by OGTT after 8-week intervention. (D–E) Insulin level were tested by ITT after 8-week intervention (n = 6/group).
Bacterial 16S rRNA sequencing, based on the V3-V4 hypervariable region,
was used to analyze the effects of TZT on GM dysbiosis in IGR rats. An average of
63,436 raw reads were generated from each sample. After removing low-quality
sequences, 57,928 optimized sequences were analyzed and clustered into OTUs
(Supplementary Table 1); the average length of an optimized sequence was
412 bp. Rarefaction analysis showed the sequencing depth covered rare and new
phylotypes and most bacterial diversity (Supplementary Fig. 1). In
total, 12 phyla, 210 genera, 371 species, and 989 OTUs were generated.
The effects of TZT on gut microbial abundance and diversity in IGR rats. (A) Sobs index. (B) Shannon index. (C) Chao1 index. (D) Venn diagram analysis. (E) OTU distance-based PCA, and weighted unifrac-based PCoA (F) ANOSIM analysis. (G–H) A histogram of relative bacterial abundance at the phylum level.
From the Venn diagram analysis, 421 common OTUs were identified in the four
groups, but OTUs in IGR and IGR+TZT groups were
To further investigate overall differences in
To examine the effects of TZT on gut microbial composition in IGR rats, we analyzed the relative abundance of gut bacteria at phylum and genus levels. The abundance of Patescibacteria, Verrucomicrobiota, and Elusimicrobiota was statistically different in the four groups at phylum levels. When compared to the ND and ND+TZT groups, Patescibacteria and Elusimicrobiota were decreased in the IGR and IGR+TZT groups (Fig. 4A). When compared to the IGR group, Verrucomicrobiota was significantly decreased in the IGR+TZT group.
To further examine differences between samples, a genus level analysis was performed. As showed (Fig. 4B), the HFD decreased the relative abundance of norank_f_norank_o_Clostridia_UCG-014, whereas TZT reversed these alterations. The HFD increased the relative abundance of Streptococcus, Ruminococcus_gauvreauii_group, norank_f_Lachnospiraceae, norank_f_Oscillospiraceae, Colidextribacter and Ruminococcus_torques_group, whereas TZT reversed these alterations. When compared with the IGR group, the proportion of the genera, Adlercreutzia, Parvibacter, Enterorhabdus, Akkermansia and Alloprevotella were significantly decreased after gavage with TZT, and the proportion of Christensenellaceae_R-7_group, norank_f_norank_o_Clostridia_UCG-014, UCG-005, Eubacterium_nodatum_group, Family_XIII_AD3011_group, norank_f_Christensenellaceae, Allobaculum, Marvinbryantia, Hungatella, and Globicatella was increased (Fig. 4C).
LEfSe was used to perform multi-level species difference LDA based on taxonomic composition in the four groups (Fig. 4D,E). In the Firmicutes phylum, Lactobacillus and Monoglobus genera were over-represented in the ND group. The norank_f_norank_o_Clostridia_UCG-014 genus was more abundant in the ND+TZT group. The norank_f_Lachnospirales, Streptococcaceae, Ruminococcus_gauvreauii_group, Colidextribacter, norank_f_Oscillospiraceae and Ruminococcus_torques_group genera were more abundant in the IGR group. The abundance of unclassified_f_Lachnospiraceae, Blautia, Christensenellaceae_R-7_group, and Lachnoclostridium genera was higher in the IGR+TZT group.
When compared with the ND group, the lymph node CD4
TZT modulates CD4+ T cell subset proportions in rat mesenteric lymph nodes. (A–B) The proportion of CD4+ T cell subsets in mesenteric lymph nodes in the four groups. (C–D) The proportion of Th1 cell subsets in mesenteric lymph nodes of the four groups. (E–F) The proportion of Th2 cell subsets in mesenteric lymph nodes in the four groups. (G–H) The proportion of Treg cell subsets in the mesenteric lymph nodes in the four groups (n = 6/group).
Redundancy analysis (RDA) and Canonical correspondence analysis (CCA) were used
to identify relationships between environmental factors and microbial
composition. Environmental factors included serum INS, IL-2, TNF-
Pearson correlation analyses between alternated microbiota, serum parameters, and T cell subsets. (A) RDA analysis at the phylum level. (B) Spearman correlation heatmap at the phylum level. (C) RDA analysis at the genus level. (D) Spearman correlation heatmap at the genus level.
Treg (p
LC-MS fecal metabolomics analysis was used to identify different metabolomics features in the four groups. Both PCA and orthogonal partial least-squares discrimination analysis (OPLS-DA) score plots showed significant differences between groups, indicating that a different glycemic status exerted different fecal metabolomics profiles (Fig. 7A,B). Permutation testing showed no over-fitting data and validated the partial least-squares discrimination analysis (PLS-DA) model (Supplementary Fig. 4). To reflect variations between group samples and overall metabolic differences between groups, PCA was performed for ND vs. ND+TZT, IGR vs. IGR+TZT, and ND vs. IGR. The PCA score plot showed the partitioning trend between ND and IGR group samples was obvious, and partitioning trends between IGR and IGR+TZT group samples were also obvious. These observations suggested that fecal metabolites in IGR animals changed and that fecal metabolites were also altered after TZT (Fig. 7C–H).
Fecal metabolomics analysis. (A–B) PCA and OPLS-DA analyses. (C–D) PCA analysis between the IGR and IGR+TZT groups. (E–F) PCA analysis between the ND and ND+TZT groups. (G–H) PCA analysis between the IGR and ND groups.
To explore gut flora species that were significantly associated with potential
metabolites, an integrated analysis of metabolomics and metagenomics was
performed in groups. Firstly, a Procrustes analysis was performed to assess data
consistency from the gut microbiome and fecal metabolomics profiling; the
similarity between the two datasets was low although significance was identified
between the IGR vs. IGR+TZT groups and ND vs. IGR groups (p
Procrustes analysis. (A) Procrustes analysis between the IGR vs. IGR+TZT group. (B) Procrustes analysis between the ND vs. IGR group.
LC-MS metabolomics analyses identified 21 differentially enriched metabolites between the four groups (Fig. 9A).
Correlation analyses between alternated microbiota and alternated fecal metabolites. (A–B) Correlation between fecal metabolic and microbial phylum. (C–D) Correlations between fecal metabolic and genus.
Next, we analyzed possible correlations between altered fecal metabolites and microbial phylum or genus using Spearman’s correlation analysis. Correlation analyses at the phylum level (Fig. 9B,C) showed that metabolite M6 content in feces was positively correlated with Cyanobacteria (r = 0.490), Patescibacteria (r = 0.128), and Actinobacteriota (r = 0.659). Alpha-muricholic acid, cholic acid, and taurine were positively correlated with Desulfobacterota (r = 0.611, r = 0.657, and r = 0.620, respectively). Multiple metabolites were positively correlated with Campilobacterota, while pregnanediol was negatively correlated with Campilobacterota (r = –0534). Asteltoxin, guanine, and deoxyguanosine were negatively correlated with Bacteroidota (r = –0.510, r = –0.533, and r = –0.529, respectively). Pregnenolone was negatively correlated with Actinobacteriota (r = –0.623).
At the genus level, Adlercreutzia was negatively correlated with
megaphone (r = –0.488), 11-dehydro-thromboxanw B (TXB) (r = –0.491),
camellenodiol (r = –0.601), perulactone (r = –0.503), lucyin A
(r = –0.511), and pregnenolone (r = –0.486).
Christensenellaceae_R-7_group was positively correlated with
21-
Kyoto Encyclopedia of Genes and Genomes pathway enrichment and pathway topology analysis were performed. Based on metabolite changes between IGR and IGR+TZT groups, five metabolic pathways exerted a high impact and included, tryptophan metabolism, retinol metabolism, taurine, and hypotaurine metabolism, brassinosteroid biosynthesis, and steroid hormone biosynthesis (Fig. 10).
Topology analysis of metabolic pathways between the
IGR and IGR+TZT groups. The X-axis represents the pathway impact and the Y-axis
represents pathway enrichment. Larger sizes and darker colors represent greater
pathway enrichment and higher pathway impact values. Ⅰ: Steroid hormone
biosynthesis; Ⅱ: Tryptophan metabolism; Ⅲ: retinol metabolism; Ⅳ: taurine and
hypotaurine metabolism; Ⅴ: brassinosteroid biosynthesis. * p
In summary, by combining GM phylum and genus associations with fecal
metabolites, Patescibacteria, Verrucomicrobiota,
Bacteroidota, Actinobacteriota and their associated metabolites
T2DM is a complex polygenic genetic disease and is generated by the combined actions of genetic and environmental factors [26]. In recent years, the relationship between T2DM and GM has become a topical research field. The GM inhabit the gut and are symbiotic with the host, thus they affect the host body’s metabolism and immune functions to varying degrees [27]. The gut’s innate immune system is the first line of defense against different bacterial antigens. Species diversity is an important indicator of intestinal health as it helps maintain a balanced healthy gut. GM diversity is more abundant in healthy individuals, while it is lower in obese and T2DM individuals. In our study, community richness and the Sobs index were significantly decreased in the IGR group. When compared with this group, community and Sobs indices were increased in the IGR+TZT group which suggested that post TZT intervention, GM in IGR rats had become richer. Magne F et al. [28] showed that when compared with healthy individuals, the Firmicutes to Bacteroidetes ratio was increased in obese and diabetic patients, while in a probiotic supplemented population, the Bacillus perfringens (Firmicutes representative) to Bacteroides fragilis (Bacteroidetes representative) ratio was significantly reduced [29, 30, 31]. In our study, when compared with the ND group, Firmicutes and Bacteroidetes ratios were also increased in IGR rats and suggested GM dysbiosis at the IGR stage.
The relative abundance of Patescibacteria and Elusimicrobiota
at the phylum level decreased in the IGR group, and Verrucomicrobiota
abundance decreased following TZT exposure. We found that
Patescibacteria abundance decreased in the HFD-induced IGR group,
consistent with Lu et al. [32]. Also, Patescibacteria
was negatively correlated with FPG, 2 h PG, INS, and Tregs, and
positively correlated with Th1 and TNF-
It was reported that beneficial bacteria belong to the Ruminococcus UCG-005 family which is a key bacterium for diabetes prevention [43]. When compared with the IGR group, the IGR+TZT group significantly increased UCG-005 levels, which agreed with our assumption that TZT may increase the beneficial bacteria. Consistently, TZT ameliorated impaired glucose regulation by modulating GM composition. TZT treatment was highly correlated with Oscillospiraceae, Adlercreutzia, Christensenellaceae_R-7_group, norank_f_norank_o_Clostridia_UCG-014, UCG-005, and Eubacterium_nodatum_group levels.
Several studies confirmed that GM is closely related to the immune system,
intestinal mucosal immunity, and parenteral immunity [44, 45]. Probiotics not only
directly affect immune function but also indirectly regulate the immune state
[10, 11, 46]. Studies have shown that CD4
Interactions occur between the intestinal microbiota and the host immune system
[53, 54]. Using redundancy analysis (RDA)/canonical correspondence analysis (CCA)
analysis, Tregs and INS had a considerable impact on microbiota phyla and genus
abundance. Insulin resistance is a key characteristic of patients with IGR, so we
hypothesize that different GM compositions in IGR may be related to INS content.
At the phylum level, Elusimicrobiota, Proteobacteria,
Patescibacteria and Bacteroidota are negatively correlated with INS and
Treg. These bacteria phylum may play a significant role in gut immunity and
insulin resistance. But these phyla contain many specific genus and species, with
complex interactions between the specific bacteria and immunity. Therefore, more
efforts should be paid to the functional role of gut microbiota rather than the
identification of specific bacterium species in the further study. Shi et al. [55] showed that Tregs were essential for peripheral immune tolerance and
preventing autoimmunity and tissue damage. Wen et al. [56] reported that
the Treg/Th17 ratio was significantly lower in the peripheral blood of IGR and
T2DM patients when compared with the normal population, and suggested a Treg/Th17
imbalance may be a risk factor for prediabetes and diabetes patients. Regulatory
T cells (Treg) control mitochondrial function and cytokine production by
CD4
Microbial-related metabolites, such as short-chain fatty acids (SCFAs), Trimetlylamine oxide (TMAO), bile acids, and neurotransmitters are important molecules in the microbiota-host-target organ axis [57]. We observed that cholic acid and muricholic acid were more abundant in the IGR group, but were reversed in the IGR+TZT group. Secondary bile acids antagonize the nuclear membrane farnesoid X receptor (FXR) and the G protein-coupled receptor TGR5 in the intestines. Some bile acid metabolites can both improve as well as exert negative effects on gut barrier tight junction function [51]. Stenman LK et al. [58] showed that bile acids and their receptors affect intestinal barrier integrity, and exhibited increased gut permeability in mice fed a diet containing Deoxycholic acid (DCA) compared with mice fed a conventional diet. In addition, DCA exacerbated lipopolysaccharide-induced barrier disruption. Consistent with the findings of Stenman LK et al. [58], in our current study, hyocholic acid, cholic acid, 12-ketolithocholic acid, Alpha-muricholic acid, and Deoxycholic acid were significantly elevated in the IGR group, suggesting that these bacterial metabolites may affect the integrity of the intestinal barrier in rats, and leads to the occurrence of metabolic endotoxemia, which in turn causes insulin resistance and accelerates the occurrence of T2DM. In the IGR+TZT group, hyocholic acid, cholic acid, 12-ketolithocholic acid, Alpha-muricholic acid, and Deoxycholic acid were significantly reduced, indicating that TZT may act on gut microbiota and different bile acids to protect the integrity of the intestinal barrier. Alpha-muricholic acid, cholic acid, and taurine were positively correlated with Desulfobacterota in our study. This suggested that TZT may affect the metabolic role or abundance of some bacteria genus or species in phylum Desulfobacterota and modulate secondary bile acids.
We used integrative analyses, microbial diversity, and an LC-MS based metabolomics approach to study GM diversity and fecal metabolic variations after TZT administration in IGR rats. Notably, TZT prevented gut dysbiosis in IGR rats by restoring the microbial richness and diversity. Meanwhile, different fecal metabolic profiles were identified after the intervention, and some profiles correlated with altered bacterial levels, suggesting TZT not only altered GM composition but also substantially altered fecal metabolomic profiles related to the gut microbiome, resulting in antidiabetic effects.
In this study, Illumina Miseq high-throughput sequencing was used to analyze the
distribution characteristics of intestinal flora in four rat groups: ND, ND+TZT,
IGR, and IGR+TZT. We sought to identify key bacteria which promoted diabetes to
provide further interventions for disease diagnosis and treatment. Our study is
the first to explore correlations between the hypoglycemic effects of TZT and T
lymphocyte subsets. We showed that TZT changed the gut microbiota composition and
significantly reduced CD4
RN and YG designed the research study. BZ performed the research. BZ and RN conducted the study and drafted the manuscript. YG and YJ provided administrative support. BZ and LW collected and assembled data. All authors contributed to editorial changes in the manuscript. All authors read and approved the final manuscript.
The study was approved by the Ethic Committee of Xinjiang Medical University (IACUC-20201026-24).
The authors thank Major Bio-Pharm Technology Co. Ltd., (Shanghai, China) gave support on microbial sequencing. The authors thank Xinjiang Key Laboratory of Molecular Biology for Endemic Disease gave support to the lab research.
This work was supported by the National Natural Science Foundation of China (no. 81860743); and the Innovation Team Foundation of the Xinjiang Uyghur Autonomous region of China (no. 2022D14009).
The authors declare no conflict of interest.
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